Cesarean Delivery in a Parturient With “Repaired” Congenital Mitral Dysplasia and Severe Functional Mitral Stenosis: A Case Report

We present the anesthetic management of a 23-year-old gravida 2 para 0-0-1-0 with a history of mitral valve replacement secondary to congenital mitral dysplasia. The hemodynamic changes of pregnancy had resulted in severe functional mitral stenosis of her mechanical valve, which was significantly un...

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Detalles Bibliográficos
Autores principales: Johnson, Erica M., Dolak, James A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health, Inc 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190049/
https://www.ncbi.nlm.nih.gov/pubmed/32784321
http://dx.doi.org/10.1213/XAA.0000000000001203
Descripción
Sumario:We present the anesthetic management of a 23-year-old gravida 2 para 0-0-1-0 with a history of mitral valve replacement secondary to congenital mitral dysplasia. The hemodynamic changes of pregnancy had resulted in severe functional mitral stenosis of her mechanical valve, which was significantly undersized for her current body surface area. Her complex cardiac history required our multidisciplinary team to focus on peripartum anticoagulation management, extracorporeal membrane oxygenation (ECMO) preparation under a dural puncture epidural (DPE) technique, and managing the hemodynamic changes that are critical for a congenital heart disease parturient.

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